Conservative treatment

The conservative (nonsurgical) treatment of adiposity comprises nutritional consultations and changes, exercise therapy, and if needed psychological counseling. The therapy program lasts six months or longer. Additional diseases associated with obesity are also being treated.

kons. Adipositasbehandl-Prof. Blüher
At the obesity outpatient clinic of the University Hospital Leipzig patients are being treated individually.

What to do in case of adiposity?

The non-surgical treatment of adiposity can be divided into two main areas: the adiposity itself and its accompanying diseases. Treating the associated secondary diseases mostly is possible with conservative means (weight reduction, drugs, exercise programs). Before adiposity can be treated often there is a long search for the causes beforehand. Since morbid overweight is a chronic disease with various causes, it cannot be healed with one single measure. It needs lifelong attendance and change of lifestyle in most cases.  Below you can find frequently asked questions and their answers.

The focus is on the individual in research and treatment

The causes of obesity may be very different and individual, therefore it is necessary for every patient to be treated individually. The treatment offer at the IFB range from personal nutritional advice over drug-based therapies, psychological attendance to surgical options. The IFB obesity outpatient clinics e. g. offer different therapy-programs.
The closeness to research is unique at the IFB. The close cooperation of physicians and scientists ensures a treatment that is always based on current research results. Many patients support the research by taking part in studies. Clinical research has a long tradition at the University of Leipzig. The patients can thus be treated faster and better with modern techniques. Many patients appreciate the complete support within such studies. The IFB AdiposityDiseases stays with this tradition in order to have patients who suffer from adiposity and its accompanying diseases benefit directly from new research findings.

Frequently asked questions and answers about the conservative adiposity treatment

When do I have to seek treatment for my overweight?

The so-called body mass index (BMI) is a first clue. If its value exceeds 25 kg/sqm you are overweight according to the World Health Organisation, if it exceeds 30 you are adipose, or morbidly overweight. The BMI itself does clarify how harmful the overweight is, however. Here the so-called waist to hip ratio (WHR) helps. It measures the relation of belly fat to hip fat. If it exceeds 0.85 in women and 1.0 in men an increased risk for accompanying diseases can be assumed. You should seek medical attendance if you:

  • have a BMI of more than 35 kg/sqm and
  • a WHR of more than 0.85/1.0

Generally fat tissue predominantly on thighs and hip is less harmful than visceral fat depots, since the former does not affect metabolism. If a patient suffers besides the overweight from diseases like high blood pressure, diabetes or arteriosclerosis, a it is necessary to see an internal specialist. With a referral by an internist or a paediatrician obese adults or children and youths can get an appointment at our adiposity outpatient clinics.

My health does not allow me to do sports. What can I do?

Every form of exercise counts for the body just as the frequency does. You don't necessarily have to do sports but being physically active is important. Try to incorporate exercise like walking instead of driving into your everyday life. If you have problems walking, try riding a bike or swimming. If you don't like to go to the public swimming pool, join a support group and go together with others. Your muscles need regular activation by all means.

What do I do against the hunger?

First of all, hunger is a natural reaction of the body. It can, however, be caused by a series of metabolic processes that do not go along with an actual undersupply of the body. Because the causes a multifaceted, it is worthwhile to write a “hunger journal”. Try to evaluate the strength of your hunger on a scale from 1-5 in certain situations over some weeks. Can you distinguish hunger from appetite? Ask your family doctor or internal specialist whether they can help you with the interpretation of your findings afterwards. If you find out the cause for your hunger you increase the possibility to be able to do something against it.

I am supposed to go to a psychosomatic consultation. I didn't only imagine all of this, did I?

Psychosomatic medicine does not mean that you only imagined it. Your body reacts to a situation in your environment with very real symptoms. For example you can have arrhythmia without your heart being actually sick. The causes can be too much stress at work, unfriendly colleagues or similar things. The arrhythmia is real but its cause is not physical but psychological. Just like that your body can also react to stress with weight gain. Stress can result from grief or excessive demands, but also from arguments with other people, sickness, noise or wrong diet. In order to get to the bottom of that a psychosomatic consultation might be helpful.

I would like to be just operated. Is that also possible without the whole program around it at your center?

A surgical intervention removing a part of the stomach or inserting a gastric bypass does indeed lead to a massive weight loss in a short time. But this is still a serious surgery that can only be the last part of a long chain of measures. After this kind of surgery you will have to exercise a lot of discipline for the rest of your life. You will have to adhere to a strict diet plan, go to regular follow-up care visits and exercise a lot of patience. Getting prepared beforehand for this future life with the help of our program is therefore inevitable and essentially important for you. After bariatric surgery the obesity outpatient clinc provides a profound after acre program.

Is there a drug against adiposity?

Because adiposity is an illness with various causes it depends on those causes whether a drug will support the weight reduction or remain ineffective. This question can only be answered after a comprehensive diagnosis. Your family physician would be your first contact person. THE drug against adiposity, however, does not exist.

Which is the best diet?

The best diet is the one you can live with. A diet for weight reduction should contain 15-20 percent less calories than you need and should be viable for the rest of your life even after the weight reduction. Investigations have proven that low fat diets are equally effective as low carb diets, but the latter are harder to be maintained for a long time. Essentially a diet should be a modification of your nutrition where the amount of food you feel good with is achieved mostly by adding a large part of fruits and vegetables. That means, if you need a large amount to feel satiated and content you have to try to eat big amounts of food that is low in calories. Those would mostly be fruits and vegetables with a high water content. The fact that a body can only lose weight when its intake in calories is lower than its demand is a rule that could not be negated until now.

My life is very stressful, but when I'm stressed I cannot make a diet. What should I do?

Stress is an alarm status for the body. Looking back thousands of years, stress mostly was connected to a threat to life, i.e. a famine, a real threat by animals or other tribes. Stress means for the body to prepare for the extreme. It will need all the energy it can store now. Unfortunately those mechanisms do not work intelligently. In times of stress the body will crave energy even if it already has enough reserves. And even if the stress is not life-threatening for example at work, the warning signs for the body are still the same, meaning that it will still start the survival program no matter whether the danger is real or not.
That is one possible explanation for the problem. The solution should be to get rid of the stress source, learning to live with the stress or develop mechanisms to reduce the stress. Health insurance companies offer courses for stress reduction. A behavior therapy might help to learn to better deal with stress. In some cases only a radical change in living conditions can help against the stress. Your family physician and your health insurance can support you with the search for solutions.

When I am on a diet I do not enjoy food anymore. Can I change that?

Additionally to cover the daily food requirements, food has a variety of duties. This does not only show in old sayings such as "The way to a man's heart is through his stomach". And actually food parts (i.e. sugar) can cause good feelings in the brain. Some are very perceptible for those feelings, some hardly are. If you are very perceptible to them your body will not only need food to cover its energy demands but also in order to be content and happy. Your body could achieve this by other means as well, but it has learned that food works the quickest and most effective. If you deprive your body of the food it has grown accustomed to it will resist for example with a bad mood and mood swings. It is the fight against old habits that you will have to fight bravely. If you hang in there, you will be able to enjoy your food again. Learning to be content and happy by doing something else than eating is hard work but it is not impossible.

I do not understand why I keep gaining weight, I don't even eat that much.

A food journal is sometimes very time-consuming and hard work, but unfortunately it is equally effective. Document honestly what you have eaten and drunk and in which amount for at least a week. If you have a calories book you can determine the number of calories of your meals at the end of the day. It often happens that your feeling will be betraying and you will have taken in more calories at the end of the day than you would have thought. That often happens because the energy content of drinks is underestimated. This happens because many foods contain a lot of calories even in a small amount. This is typical for the Western World. That is basically the same like the comparison between one pound of lead and one pound of feathers. The weight is the same but the amount is extremely different. For example, for 500 calories you can either eat a whole grain roll with butter and salami or four plates of broccoli.